INSTRUMENTS + APPLICATION

Question 1

Answer 1

-scissors:

Mayo

> dissecting soft tissue
thick blades approximately 1/3 of the length

> TRIPOD (thumb-ring finger) grip

• Used to cut or dissect tissue and to cut inanimate objects
• Cutting of inanimate objects should be limited to specific instruments
• Tripod (thumb–ring finger) grip is recommended – maximal control
• Using the end of the blade stabilizes tissue more securely and allows
  a more precise cut
• Can be curved/straight, tips are sharp/blunt
• Curved scissors – greater maneuverability and visibility
• Straight scissors – mechanical advantage for cutting dense tissue
• Sharp (regular cutting) and blunt dissection possible

Question 2

Answer 2

-scissors:

Metzenbaum

> dissecting delicate soft tissue
thin delicate blades approximately 1/4 of the overall length

> TRIPOD (thumb-ring finger) grip

• Used to cut or dissect tissue and to cut inanimate objects
• Cutting of inanimate objects should be limited to specific instruments
• Tripod (thumb–ring finger) grip is recommended – maximal control
• Using the end of the blade stabilizes tissue more securely and allows
  a more precise cut
• Can be curved/straight, tips are sharp/blunt
• Curved scissors – greater maneuverability and visibility
• Straight scissors – mechanical advantage for cutting dense tissue
• Sharp (regular cutting) and blunt dissection possible

Question 3

Answer 3

-scissors:

Tenotomy

> delicate and accurate procedures

> orthopedic, plastic surgery, eye surgery, neurosurgery

> TRIPOD (thumb-ring finger) grip

• Used to cut or dissect tissue and to cut inanimate objects
• Cutting of inanimate objects should be limited to specific instruments
• Tripod (thumb–ring finger) grip is recommended – maximal control
• Using the end of the blade stabilizes tissue more securely and allows
  a more precise cut
• Can be curved/straight, tips are sharp/blunt
• Curved scissors – greater maneuverability and visibility
• Straight scissors – mechanical advantage for cutting dense tissue
• Sharp (regular cutting) and blunt dissection possible

Question 4

Answer 4

-needle holders:

Mayo-Hegar

> needle holders: grips:
1. Thenar grip
2. Thumb-ring finger grip (TRIPOD)
3. Palmed grip
4. Pencil grip

• Jaws short and frequently have grooves that are cross-hatched on the
  surface intended to limit twisting and rotation of the needle
• Should match both the size and the type of the needle being used
• Different locking mechanisms possible
• Needles placed perpendicular to the needle holder– greatest
  maneuverability
• Needle is generally grasped near its center

Question 5

Answer 5

-needle holders:

Olsen-Hegar

> needle holders: grips:
1. Thenar grip
2. Thumb-ring finger grip (TRIPOD)
3. Palmed grip
4. Pencil grip

• Jaws short and frequently have grooves that are cross-hatched on the
  surface intended to limit twisting and rotation of the needle
• Should match both the size and the type of the needle being used
• Different locking mechanisms possible
• Needles placed perpendicular to the needle holder– greatest
  maneuverability
• Needle is generally grasped near its center

Question 6

Answer 6

-needle holders:

Mathieu

> needle holders: grips:
1. Thenar grip
2. Thumb-ring finger grip (TRIPOD)
3. Palmed grip
4. Pencil grip

• Jaws short and frequently have grooves that are cross-hatched on the
  surface intended to limit twisting and rotation of the needle
• Should match both the size and the type of the needle being used
• Different locking mechanisms possible
• Needles placed perpendicular to the needle holder– greatest
  maneuverability
• Needle is generally grasped near its center

Question 7

Answer 7

-CRUSHING tissue forceps:

Allis tissue forceps

> CRUSHING TISSUE FORCEPS
should be used to grasp only tissue slated for excision (those that are removed, going to damage tissue)
toothed jaws

• Multiple types of forceps of various sizes and shapes available
• Used for a variety of tasks
• Configuration of jaw serrations determines their use
• Cross-serrations– tip-clamping
• Longitudinal serrations– jaw-clamping

Question 8

Answer 8

-NON-crushing tissue forceps:

Doyen intestinal forceps

• Doyen forceps considered noncrushing, but actually
  induce tissue trauma (dependent on use duration)
• Other noncrushing tissue forceps include:
• Various peripheral vascular clamps
• Partial occlusion forceps

Question 9

Answer 9

-Hemostatic forceps:

Halsted-Mosquito hemostats

• Crushing instruments used to clamp blood vessels
• Serrations on the jaws may be transverse, longitudinal, diagonal, or a
  combination of these
• Longitudinal serrations are generally gentler to tissue than cross-
  serrations
• As little tissue as possible should be grasped to minimize trauma
• The least amount and duration of pressure applied by closure of the
  ratchet on the instrument is the goal

Question 10

Answer 10

-Hemostatic forceps:

CRILE hemostats

• CRUSHING instruments used to clamp blood vessels
• Serrations on the jaws may be transverse, longitudinal, diagonal, or a
  combination of these
• Longitudinal serrations are generally gentler to tissue than cross-
  serrations
• As little tissue as possible should be grasped to minimize trauma
• The least amount and duration of pressure applied by closure of the
  ratchet on the instrument is the goal

Question 11

Answer 11

-Hemostatic forceps:

Kelly hemostats

• Crushing instruments used to clamp blood vessels
• Serrations on the jaws may be transverse, longitudinal, diagonal, or a
  combination of these
• Longitudinal serrations are generally gentler to tissue than cross-
  serrations
• As little tissue as possible should be grasped to minimize trauma
• The least amount and duration of pressure applied by closure of the
  ratchet on the instrument is the goal

Question 12

Answer 12

-Hemostatic forceps:

Rochester-Carmalt hemostats

• Crushing instruments used to clamp blood vessels
• Serrations on the jaws may be transverse, longitudinal, diagonal, or a
  combination of these
• Longitudinal serrations are generally gentler to tissue than cross-
  serrations
• As little tissue as possible should be grasped to minimize trauma
• The least amount and duration of pressure applied by closure of the
  ratchet on the instrument is the goal

Question 13

Answer 13

-thumb forceps:

Brown-Adson forceps

• Tweezer-like, nonlocking instruments used to grasp tissue (and
  inanimate objects)
• Available in various shapes and sizes; tips may be pointed, flat, round,
  smooth, or serrated with small or large teeth
• Pencil grip preferred
• Can be held in the palm of the nondominant hand when temporarily
  not in use

Question 14

Answer 14

-thumb forceps:

Adson forceps

• Tweezer-like, nonlocking instruments used to grasp tissue (and
  inanimate objects)
• Available in various shapes and sizes; tips may be pointed, flat, round,
  smooth, or serrated with small or large teeth
• Pencil grip preferred
• Can be held in the palm of the nondominant hand when temporarily
  not in use

Question 15

Answer 15

-thumb forceps:

Dressing forceps

• Tweezer-like, nonlocking instruments used to grasp tissue (and
  inanimate objects)
• Available in various shapes and sizes; tips may be pointed, flat, round,
  smooth, or serrated with small or large teeth
• Pencil grip preferred
• Can be held in the palm of the nondominant hand when temporarily
  not in use

Question 16

Answer 16

-towel clamps:

Backhaus towel clamps

Question 17

Answer 17

-towel clamps:

Jones towel clamps

Question 18

Answer 18

-Hand-held retractors:

Senn retractor

• Help improve exposure by deflecting tissue away from the area of
  interest
• Available in hand-held and self-retaining varieties
• Some handheld retractors may be bent to conform to the area of the
  body being retracted
• Moistened towels or pads are frequently placed under self-retaining
  and selected hand-held retractors to minimize trauma and drying

Question 19

Answer 19

-Self-retaining retractors:

Gelpi retractor

• Help improve exposure by deflecting tissue away from the area of
  interest
• Available in hand-held and self-retaining varieties
• Some handheld retractors may be bent to conform to the area of the
  body being retracted
• Moistened towels or pads are frequently placed under self-retaining
  and selected hand-held retractors to minimize trauma and drying

Question 20

Answer 20

-Self-retaining retractors:

Weitlaner retractor

• Help improve exposure by deflecting tissue away from the area of
  interest
• Available in hand-held and self-retaining varieties
• Some handheld retractors may be bent to conform to the area of the
  body being retracted
• Moistened towels or pads are frequently placed under self-retaining
  and selected hand-held retractors to minimize trauma and drying